Helen got to her room after hip surgery around 9:00 p.m., after about four hours in the recovery room.  To catch her surgeon the next morning, I assumed that I needed to be at the hospital by 5:30 or 6:30 a.m., as surgeons typically round (visit patients) before they go into the operating room or office. 

“Oh, no!” I was told.  “None of the doctors gets here until 8:00 or 9:00 a.m.”

When I arrived at 7:20 a.m., I found that the surgeon had come and gone by 6:30 a.m. After that, I arrived each day before 5:30 a.m.

But because I didn’t see the surgeon on that critical first day after surgery, I didn’t have a chance to ask questions about Helen’s care plan for the day.  Helen was permitted to have 2 mg of morphine hourly, as needed for pain.  I would have asked how I could tell if I were requesting more than she needed, or not requesting enough.  I would have asked what problems might arise with the drug that could delay her recovery.

 Without any meaningful guidance on these issues, I asked for only about a third as much as she was allowed.  But when the physical therapists came, she was nevertheless too sedated to be roused, and they left without treating her. 

The surgeon had previously predicted that Helen would leave the hospital 3-5 days after surgery.  But the next morning, he told me that she wouldn’t be leaving any time soon if she weren’t alert enough to participate in physical therapy.  He said that she could have only Tylenol from then on.  I felt blind-sided.  How was I to know that by asking for a fraction of the morphine he had ordered, I was consigning Helen to a longer hospital stay and at least a slightly slower recovery?

What can you do to avoid similar setbacks in a relative’s care?

First, ask the surgeon -- before surgery -- who will do rounds the morning after surgery, and roughly when.  (Sometimes one surgeon in the practice will visit all the practice’s patients.) 

Second, when the patient gets to her room after surgery, ask the nurse to tell you what drugs she is supposed to get, and how often.  Write this information down.

Third, the next morning, be there to ask the surgeon to confirm that your drug list is accurate, and ask what other therapies have been ordered to help the patient recover.

Fourth, ask about side effects of the drugs – especially painkillers – that could interfere with the other therapies.  Ask how you will know if the patient is too sedated.

With this information, you can help your relative’s recovery stay on track.